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As part of the study of the early medieval cemetery at Broechem (Belgium), human bones from 32 cremation graves have been dated through radiocarbon (14C) analysis. It was noted that many of the dates were not in accordance with the chronological ranges provided by the characteristics of the cultural artifacts deposited in the graves. In fact, the human bones were “older” than the artifacts. Subsequently, a number of animal bones (in all cases from domestic pigs) was radiocarbon dated, yielding dates that were more consistent with the information from the cultural artifacts than the human bones. The dates obtained on human and pig bones from the same grave often differed around 100 radiocarbon years. This paper tries to find an explanation for the pattern observed, concentrating on two hypotheses: aquatic reservoir versus old wood effects. The evaluation takes into account additional radiocarbon dates derived from charcoal fragments of the funeral pyre, from both short-lived and long-lived taxa. A conclusive explanation for the anomalous radiocarbon dates could not be reached but clear suggestions can be put forward for future experimental work that will without doubt shed more light upon the interpretational problems raised.
Muscle and bone have been considered a functional unit that grows together early in life, deteriorates with aging, and can cause osteosarcopenia. Due to its importance in public health, detecting risk factors in early life is desirable. This study examined whether birth weight (BW) was associated with muscle–bone unit using dual energy X-ray absorptiometry (DXA) parameters in young women from the Nutritionists’ Health Study (NutriHS), a cohort study of undergraduates and Nutrition graduates. This cross-sectional analysis included 170 young healthy women who answered early life events-questionnaire, and had anthropometric, muscle tests and DXA-determined body composition and bone densitometry (iDXA-Lunar®). A blood sample was obtained for a subsample of 148 participants. Appendicular skeletal muscle mass index (ASMI) was calculated. BW was categorized in quartiles (BWq) and variables of interest compared by ANOVA. Associations of BWq with calf circumference (CC), handgrip, muscle performance tests, ASMI, bone mineral density and content (BMD and BMC), and plasma glucose, lipids, insulin, and 25-hydroxyvitamin D were performed using multiple linear regression and directed acyclic graph-recommended adjustments. Mean values of age, body mass index, and BW were 23.0 years (20.0–28.0), 22.9 ± 2.9 kg/m2, and 3199 ± 424 g, respectively. Comparing variables across BWq, significant differences in CC, handgrip, ASMI, and total body BMC were detected. Regression models adjusted for confounders showed associations of BWq with CC (β = 0.72, p = 0.005), handgrip (β = 1.53, p = 0.001), ASMI (β = 0.16, p = 0.022), total body BMC (β = 64.8, p = 0.005), total femur BMC (β = 0.70, p = 0.041), total body BMD (β = 0.02, p = 0.043), and lumbar spine BMD (β = 0.03, p = 0.028). We conclude that BW is associated with muscle–bone unit using DXA-parameters in Brazilian young healthy women from the NutriHS, suggesting a role for intrauterine environment for musculoskeletal health.
To compare soft-tissue complications following implantation of different bone conduction hearing devices.
Adults who underwent implantation of different bone conduction hearing devices, between January 2008 and December 2016, were included in the study. Five groups were identified depending on the soft-tissue approach: (1) split-thickness skin flap with use of dermatome; (2) Sheffield ‘S’-shaped incision with skin thinning; (3) linear incision without skin thinning (hydroxyapatite-coated abutment); (4) ‘C’-shaped full-thickness incision for passive transcutaneous bone conduction hearing devices; and (5) post-aural incision for active transcutaneous bone conduction hearing devices. The main outcome measures were different soft-tissue complications.
The study comprised 120 patients (group 1 = 20 patients, group 2 = 35, group 3 = 35, group 4 = 20, and group 5 = 10). Soft tissue related problems were encountered in 55 per cent of patients from group 1, 26 per cent in group 2, 3 per cent in group 3, and 0 per cent in groups 4 and 5.
There was a reduction in soft tissue related complications with reduced soft-tissue handling. In addition, there was a shift from an initial skin-penetrating (percutaneous) approach to a non-skin-penetrating (transcutaneous) approach.
The implantation and controlled release of growth factors can enhance the proliferation and differentiation of cells that promote new bone formation at defect sites. Therefore, chitosan polymer microspheres were prepared by the water-in-oil emulsion (W/O) method and solvent freeze-drying, using glutaraldehyde as an ionic crosslinker, along with the lyophilization of solvents, to microencapsulate growth factors, preventing denaturation. The microspheres were loaded with recombinant bone morphogenetic protein 2 (Rh-BMP-2). They were spherical in shape, with a rough surface ranging in particle size from 0.4 to 1.6 μm. The yield percentage with respect to the polymer was 70% and the BMP-2 load was regulated by the initial protein dose. BMP-2 release experiments were performed for 7 days in PBS solutions at pH 4 and 7.4. The results showed that the protein release rate was only 2% lower at pH 7.4. BMP-2/chitosan microspheres were compatible with the MG-63 cell line (ATCC®CRL-1427™Homo sapiens bone osteosarcoma) and could be considered drug delivery vehicles in bone tissue engineering applications.
This article introduces a small group of ivories held in the Sanandaj Museum, which were discovered in 1997 during the seventh season of Nasratolah Motamedi's excavations at Ziwiye, northwest Iran. An investigation of the decorative, figurative, and stylistic characteristics of these pieces reveals a strong Neo-Assyrian influence, with close similarities to the palace reliefs of Ashurnasirpal II at Nimrud, as well as the influence of Assyrianizing Urartian art. These extensive cultural influences on Mannaean art can be seen in terms of political and economic relations with the two regions.
Pott's puffy tumour is a rare complication of sinusitis. This osteomyelitis can affect the outer and inner tables of the frontal sinus. The treatment of Pott's puffy tumour combines medical and surgical approaches. Surgical approaches have traditionally been open, but endoscopic techniques have been adopted recently in select cases. The bony defect from debridement can be left alone, or closed with autografts or allografts.
To describe a technique for the reconstruction of a large skull vault after the debridement of extensive osteomyelitis of the anterior cranial vault.
Modified distraction osteogenesis is used in the cranial vault, to induce new bone formation. This is customarily used to lengthen long bones. The advantages of this technique include avoiding autologous grafts or alloplastic cranioplasty in the infected surgical bed, and allowing primary closure.
Early post-operative imaging results have been encouraging, with no reported complications.
Modified distraction osteogenesis is a novel technique in the primary reconstruction of calvarial bone.
This study aimed to assess the potential role of pneumatisation of the mastoid and its communicating air cells in the development of middle-ear barotrauma in aircrew members.
Seventy-nine aircrew members (158 ears) underwent temporal computed tomography. All were assessed before flying by clinical examination and audiology evaluation, followed by post-flight examination to detect barotrauma.
Aircrew members’ ears were divided into 3 groups based on barotrauma and temporal bone pneumatisation: 33 ears with barotrauma and temporal bone pneumatisation of 71 cm3 or greater (group A); 12 ears with barotrauma and temporal bone pneumatisation of 11.2 cm3 or lower (group B); and 113 ears with no barotrauma (group C). Mean pneumatisation volumes were 91.05 cm3, 5.45 cm3 and 28.01 cm3 in groups A, B and C, respectively. A direct relationship was observed between volume of temporal bone pneumatisation of 71 cm3 or greater and barotrauma grade.
Pneumatisation volume of the mastoid and its communicating air cells that ranges from 11.3 cm3 to 70.4 cm3 serves as a reliable predictor of the avoidance of middle-ear barotrauma associated with flying in aircrew members who have normal resting middle-ear pressure and good Eustachian tube function.
The aim of this network meta-analysis is to compare bone mineral density (BMD) changes among different osteoporosis prevention interventions in postmenopausal women. We searched MEDLINE, Embase and Cochrane Library from inception to 24 February 2019. Included studies were randomised controlled trials (RCT) comparing the effects of different treatments on BMD in postmenopausal women. Studies were independently screened by six authors in three pairs. Data were extracted independently by two authors and synthesised using Bayesian random-effects network meta-analysis. The results were summarised as mean difference in BMD and surface under the cumulative ranking (SUCRA) of different interventions. A total of ninety RCT (10 777 participants) were included. Ca, vitamin D, vitamin K, oestrogen, exercise, Ca + vitamin D, vitamin D + vitamin K and vitamin D + oestrogen were associated with significantly beneficial effects relative to no treatment or placebo for lumbar spine (LS). For femoral neck (FN), Ca, exercise and vitamin D + oestrogen were associated with significantly beneficial intervention effects relative to no treatment. Ranking probabilities indicated that oestrogen + vitamin D is the best strategy in LS, with a SUCRA of 97·29 % (mean difference: +0·072 g/cm2 compared with no treatment, 95 % credible interval (CrI) 0·045, 0·100 g/cm2), and Ca + exercise is the best strategy in FN, with a SUCRA of 79·71 % (mean difference: +0·029 g/cm2 compared with placebo, 95 % CrI –0·00093, 0·060 g/cm2). In conclusion, in postmenopausal women, many interventions are valuable for improving BMD in LS and FN. Different intervention combinations can affect BMD at different sites diversely.
Giant cell tumor (GCT) of bone is a common benign lesion that causes significant morbidity due to the failure of modern medical and surgical treatment. Surface ultra-structures of giant cells (GCs) may help in distinguishing aggressive tumors from indolent GC lesions. This study aimed to standardize scanning electron microscopic (SEM) imaging of GC from GCT of bone. Fresh GCT collected in Dulbecco's Modified Eagle Medium was washed to remove blood, homogenized, or treated with collagenase to isolate the GCs. Mechanically homogenized and collagenase-digested GCs were imaged on SEM after commonly used drying methodologies such as air-drying, tetramethylsilane (TMS)-drying, freeze-drying, and critical point-drying (CPD) for the optimization of sample processing. The collagenase-treated samples yielded a greater number of isolated GC and showed better surface morphology in comparison to mechanical homogenization. Air-drying was associated with marked cell shrinkage, and freeze-dried samples showed severe cell damage. TMS methodology partially preserved the cell contour and surface structures, although the cell shape was distorted. GC images with optimum surface morphology including membrane folding and microvesicular structures on the surface were observed only in collagenase-treated and critical point-dried samples. Collagenase digestion and critical point/TMS-drying should be performed for optimal SEM imaging of individual GCs.
Slow-growing, male chickens raised with outdoor access have been found to be a nutritious protein source with 24.83% protein in breast muscle. They have an acceptable carcass quality with at least 20% less abdominal fat, 3% more breast yield, and 3% more thigh yield than the birds raised in confinement. Similarly, slow-growing male chickens grown with outdoor access have a good bone quality with femur weight, length and diameter (16.5 g, 96.7 mm, and 8.61 mm, respectively). Considering fatty acid profile as a meat quality trait, breast muscles of slow-growing birds grown with outdoor access compared to those without such access have significantly higher polyunsaturated fatty acids level (3.85 vs. 3.36%), lower n6:n3 PUFA ratio (7.8 vs. 9.22) and lower saturated fatty acids content (26.29 vs. 28.73%). Raising slow-growing male chickens in production systems with outdoor access has been confirmed to be beneficial for the animals, the producers, the consumers and the environment.
This study characterized cremated bone to better understand isotope exchanges during burial, using archeological samples. The cremated bones of Jokei, a Buddhist monk (AD 1155–1213), found in an urn from the Jisho-in Temple, Nara Prefecture, Japan, were used for the analysis. 14C dates were determined for eight of Jokei bone fragments of different colors (black, gray, and white). The white fragments had the highest x-ray diffractometry (XRD) crystallinity index (CI) values (0.89–1.05), Fourier-transform infrared spectroscopy (FTIR) splitting factor values (IRSF) of 5.3–7.1, and the lowest Ba concentrations. The calibrated date of the white bone fragments is 1152–1216 cal AD, consistent with Jokei’s lifespan, showing these fragments yield reliable 14C ages. Meanwhile, the black and gray fragments, which probably experienced lower temperatures during cremation, had lower CI and IRSF values of 0.25–0.46 and 4.2–4.9, respectively, and higher Ba concentrations. The black and gray fragments tended to show unreliable younger 14C dates and higher 87Sr/86Sr values close to the soil value due to soil contamination. The results in this study indicate that it is important to check crystallinity of apatite and soil contamination using chemical indexing methods such as Ba capture, to clarify the reliability of 14C dates for cremated bone samples.
The Danube region in Central Europe was one of the areas where several cultures appeared before moving further or being defeated during the Migration Period in the middle of the first millennium AD. The Lombards, who crossed the Danube in 505 AD, settled in the “Tullnerfeld” where the Maria Ponsee graveyard was excavated in 1965–1972. From the historical evidence about the temporal and spatial migration of the Lombards, it was concluded that the graveyard was in use between 505 and 568 AD by three groups of migrants. We processed and dated a new set of 23 bones, found in the Maria Ponsee site. The determined 14C dates fit well in the expected time interval, though discrimination between the grave groups could not be obtained. The dates were added to the chronological sequence, recording the Migration Period in Central Europe. The sequence lead to a good correlation of the modelled and historical data (Amodel = 87.6%). The results show differentiations of the respective tribes in the pre-Lombardic period. However, transitions between the Lombard phases were rather ambiguous, indicating that the Lombards set up new settlements while only partially abandoning the already inhabited ones before 546 AD.
Composite materials, or at least materials that could be regarded as composites, are widespread in nature. This is, of course, a reflection of the many gains in ‘efficiency’ that can be made by integration of two or more constituents. Moreover, the development of artificial composite materials, for mechanical and/or other purposes, has benefited considerably from insights gained by examining bio-composites, and by their direct utilisation. The kingdoms of both plants (wood, grasses, straw, etc.) and animals (bone, skin, teeth, marine shells, corals, etc.) offer many examples of highly successful materials that are essentially composites. Their importance relates not only to lessons about structure–property relationships, but also to the issue of degradation and recycling. While the ‘rotting’ of wood is often regarded as its Achilles’ heel, viable recycling strategies are increasingly required for all materials (and manufactured composites are often perceived as being unsatisfactory in this respect). It is clearly not appropriate in a book of this type to provide great detail about natural materials, or indeed about recycling, but a few of the main principles and issues involved are briefly summarised here.
This study aimed to evaluate the long-term results of ossiculoplasty using bone cement.
Forty patients (24 females and 16 males; mean age: 34.1 ± 11.8 years; range, 9–54 years) with chronic otitis media with perforation but without cholesteatoma who had undergone incudostapedial rebridging ossiculoplasty using bone cement were evaluated retrospectively. Pre-operative and post-operative audiograms were evaluated. Bone conduction, air conduction and air–bone gaps were calculated according to international guidelines.
There was a mean reduction in pre-operative and post-operative air conduction (12.30 ± 11.98 dB), and this result was significant (p = 0.0001). There was a mean reduction in pre-operative and post-operative bone conduction (4.30 ± 6.69 dB), and this result was significant (p < 0.0001). The pre-operative air–bone gap was 27.65 dB and decreased to 19.65 dB during follow-up (p = 0.0001). No adverse reactions or complications were observed.
Bone cement is reliable for the repair of incudostapedial-joint defects.
Radiocarbon (14C) results on cremated bone are frequently published in high-ranking journals, but 14C laboratories employ different pretreatment methods as they have divergent perceptions of what sources of contaminants might be present. We found pretreatment protocols to vary significantly between three laboratories (Brussels [RICH], Kiel [KIA], and Groningen [CIO]), which all have a long history of dating cremated bone. We present a case study of 6 sets of replicate dates, to compare laboratory pretreatment protocols, and a further 16 sets of inter-laboratory replicate measurements, which compare specific steps of the conversion and measuring process. The 14C results showed dates to be reproducible between the laboratories and consistent with the expected archaeological chronology. We found that differences in pretreatment, conversion to CO2 and accelerator mass spectrometry (AMS) measurement to have no measurable influence on the majority of obtained results, suggesting that any possible diagenesis was probably restricted to the most soluble ≤5% of each sample, as this proportion of the sample mass was removed under all laboratory protocols.
To compare round window niche visibility as seen endoscopically during cochlear implant surgery with pre-operative high-resolution computed tomography of the temporal bone.
Nineteen patients scheduled for cochlear implantation, aged 2–20 years, were referred for computed tomography from October 2016 to March 2018. Angles were measured between the lines passing through the mid-sagittal plane and cochlear basal turn on the scans. Endoscopic round window niche visibility during posterior tympanotomy was categorised as: type I = 100 per cent, type IIa = more than 50 per cent, type IIb = less than 50 per cent or type III = 0 per cent. Pre-operative computed tomography measurements were used to predict round window niche visibility before surgery and correlated with intra-operative findings.
The mean (range) of pre-operative angles on computed tomography for endoscopic visibility types I, IIa and IIb, were 64.06° (61.16–69.37°), 63.81° (58.61–71.35°) and 56.48° (50.37–59.05°), respectively, a statistically significant finding (one-way analysis of variance test, p = 0.016).
Pre-operative high-resolution temporal bone computed tomography measurements are useful in predicting round window niche visualisation as viewed endoscopically during posterior tympanotomy. The angle was more acute in type IIb compared to type I.
The Bonebridge is an active transcutaneous bone conduction implant recommended as a surgical option for adults and children (aged 5–18 years). Successful implantation of the Bonebridge is often restricted by an insufficient amount of temporal bone to house the transducer in the paediatric patient.
Method and results
In this unique paediatric case, bilateral Bonebridge devices were implanted simultaneously in the right sinodural angle and the left middle cranial fossa.
The simultaneous implantation of bilateral Bonebridge devices was well tolerated in this paediatric patient, with significant improvement in her hearing. The middle cranial fossa is a viable option for housing the transducer.
Bone is one of the most complex sample materials used for radiocarbon (14C) dating. The installation of the EnvironMICADAS AMS at HEKAL (department of ICER) in 2011 required the adoption of new sample preparation techniques for small bone samples. Since then, hundreds of procedural background and known-age bones have been processed using our modified Longin method (MLM) and dated along with unknown samples. Their results are used in this study to assess the reproducibility of our current bone preparation method and the real uncertainty of the final age result. In addition, using the background samples, which are included in each bone measurement batch, blank correction of the unknown samples could also be performed. The mean F14C value of our bone blanks is generally better than 0.005 (∼42,500 BP) alongside 0.0013 SD. Good reproducibility was confirmed by the results of the laboratory known-age bone as well, where the standard deviation of the mean is better than 0.0025. In addition, the results of the three bone samples used in an ultrafiltration (UF) test study did not show notable differences from the ones obtained by our current protocol in 1σ uncertainty range but more experiments will be performed in the near future.
Coccidial infections reduce fat-soluble vitamin status and bone mineralisation in broiler chickens. We hypothesised that broilers infected with Eimeria maxima would benefit from increased dietary supplementation with vitamin D (vitD) or with 25-hydroxycholecalciferol (25(OH)D3 or 25D3). Broilers were assigned to diets with low (L) or commercial (M) vitD levels (25 v. 100 μg/kg) supplemented as cholecalciferol (D3) or 25D3. At day 11 of age, birds were inoculated with water or 7000 E. maxima oocysts. Pen performance was calculated over the early (days 1–6), acute (days 7–10) and recovery periods (days 11–14) post-infection (pi). At the end of each period, six birds per treatment were dissected to assess long bone mineralisation, plasma levels of 25D3, Ca and P, and intestinal histomorphometry. Parasite replication and transcription of cytokines IL-10 and interferon-γ (IFN-γ) were assessed at day 6 pi using quantitative PCR. Performance, bone mineralisation and plasma 25D3 levels were significantly reduced during infection (P < 0·05). M diets or diets with 25D3 raised plasma 25D3, improved performance and mineralisation (P < 0·05). Offering L diets compromised feed efficiency pi, reduced femur breaking strength and plasma P levels at day 10 pi in infected birds (P < 0·05). Contrastingly, offering M diets or diets with 25D3 resulted in higher parasite loads (P < 0·001) and reduced jejunal villi length at day 10 pi (P < 0·01), with no effect on IL-10 or IFN-γ transcription. Diets with M levels or 25D3 improved performance and mineralisation, irrespective of infection, while M levels further improved feed efficiency and mineralisation in the presence of coccidiosis.
Three-dimensional printing (3DP) is becoming a standard manufacturing practice for a variety of biomaterials and biomedical devices. This layer-by-layer methodology provides the ability to fabricate parts from computer-aided design files without the need for part-specific tooling. Three-dimensional printed medical components have transformed the field of medicine through on-demand patient care with specialized treatment such as local, strategically timed drug delivery, and replacement of once-functioning body parts. Not only can 3DP technology provide individualized components, it also allows for advanced medical care, including surgical planning models to aid in training and provide temporary guides during surgical procedures for reinforced clinical success. Despite the advancement in 3DP technology, many challenges remain for forward progress, including sterilization concerns, reliability, and reproducibility. This article offers an overview of biomaterials and biomedical devices derived from metals, ceramics, polymers, and composites that can be three-dimensionally printed, as well as other techniques related to 3DP in medicine, including surgical planning, bioprinting, and drug delivery.